COVID-19 had radically changed the delivery of healthcare and significantly impacted the mental health of individuals and communities. The effect on the mental health of the healthcare workforce had been particularly strained throughout the various phases of the pandemic. This impact was predicted to be chronic and pervasive for all, particularly for disproportionately affected underrepresented minority and female populations. There had been a critical need to develop and test scalable digital approaches that could identify, address, and support the well-being of healthcare workers (HCWs) over time and beyond the pandemic. HCWs had been busy, and there had been stigma associated with accessing mental health support.
The team sought to leverage digital platforms to facilitate ease of access to well-being-focused resources and direct connection to mental health providers through real-time support using a stepped model of care. During the acute phase of the pandemic, the team developed and implemented Penn Cobalt across the Penn Medicine health system. Cobalt had been a web and text-message-based platform that allowed HCWs to complete contextual surveys and evidence-based assessments remotely on their own time. Individuals were then directed to tailored well-being resources and appropriate individual or group mental healthcare. Across Penn Medicine, and in just 7 months, Cobalt had 18,300 unique users and identified 111 HCWs reporting thoughts of self-harm, immediately connecting those individuals with a mental health provider for support and evaluation.
While Cobalt had sustained high engagement and increased the health system's ability to identify high-risk individuals, it required a motivated user. Individuals had to “pull” care toward them and overcome multiple barriers ranging from identifying the need for mental health support to making an appointment and attending the appointment. The team sought to evaluate whether a “pushed” model of care (Cobalt+), which proactively engaged individuals, could improve individual mental health, satisfaction with access, and decrease factors that affected workforce productivity (e.g., absenteeism).
Overall, this project sought to address a significant gap and enhance HCW access to and receipt of mental health and well-being-focused resources and care. The intent had been to enable a proactive culture of well-being and mental health support for the healthcare workforce during the multiple phases of the pandemic. The approach evaluated existing digital models that could be executed in a timely fashion and rapidly scaled for use across other health systems.
